Portrayals of mental illness in film has always been problematic given that fact that the lived experience of every sufferer is unique, making it all but impossible to understand the reality of what any given individual experiences in the day-to-day struggle to forge a place for themselves in a society where mental illness remains stigmatised and misunderstood. Such was the challenge facing director Josephine Decker with Madeline’s Madeline, an ambitious exploration of identity that plunges into the psyche of Madeline, a bi-racial high school student on the cusp of acceptance into the prestigious Juilliard acting program. Whilst the fact that Madeline is living with a mental illness is never explicitly spoken, there are plenty of not-too-subtle clues along the way, such as when her mother Regina (Miranda July) panics upon discovering that her prescription has expired. Madeline channels her volatile feelings into acting as part of an experimental theatre company whose director, Evangeline (Molly Parker), has become enamoured with the talented but unpredictable teen.

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In casting newcomer Helena Howard as the titular character, Decker has struck gold because the young actress is outstanding in a challenging role as a young woman whose struggles prove to be both a frustration and an inspiration for Evangeline, who starts to incorporate more and more of Madeline’s life – in particular her fractured relationship with Regina – into the play. As the lines between performance and reality, and imagination and appropriation, begin to blur, Madeline’s mental state spirals downwards. Regina, whose fragility may be the result of past trauma or a mental illness of her own, struggles to understand her daughter and their relationship becomes even more strained as Evangeline’s opportunistic infatuation takes hold. Madeline projects herself into her characters (a sea turtle, a cat) so effectively that it’s creepy; seemingly unable to distinguish between fantasy and reality. Smitten with her young protégé, Evangeline pushes her further and further in rehearsals and then beckons Madeline into her private sphere with an invitation to her house for dinner and when we learn that Evangeline’s husband is black, her infatuation with Madeline opens itself to an entirely new interpretation.

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In reconfiguring her project around Madeline’s tumultuous relationship with her mother, is Evangeline exploiting her new star’s mental health issues?  Furthermore, is she undermining Regina in the process?  Decker makes no effort to answer these questions definitively, leaving it for the audience to decide for themselves as the collaboration between Evangeline and Madeline builds to an unnerving conclusion that blurs the boundaries between fiction and reality. Given her treatment at the hands of both Madeline and Evangeline, Regina should perhaps earn our sympathy more than she does, but it is difficult to expend too much emotional energy on her plight when we know so little about her.

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The opening moments are frenetically photographed in a way that some may find disorienting, but it isn’t long before the blur of Ashley Connor’s (intentionally) unfocused camerawork clears sufficiently for us to come to terms with what we are seeing and meet the livewire youngster who becomes the centre of our attention and of those around her, a force that neither Regina nor Evangeline can control. Powered by Howard’s extraordinary work in her debut performance, Madeline’s Madeline will infuriate some viewers and invigorate others but should, in any case, prove a launching pad for her career. Decker, who also wrote the screenplay, delivers an unconventional, experimental, disorienting and expressionistic film that never becomes heavy-handed or overly pretentious. Unnerving at times, Madeline’s Madeline requires patience and a willingness to embrace the kinetic energy that Howard exudes as the central figure in a film that ultimately emerges as one of the better cinematic explorations of mental illness.